Substance Abuse in the Military
Members of the armed forces are not immune to the substance use problems that affect the rest of society. Although illicit drug use is lower among U.S. military personnel than among civilians, heavy alcohol and tobacco use, and especially prescription drug abuse, are much more prevalent and are on the rise.
Learn more about preventing substance abuse witin the miliary from the National Institute on Drug Abuse.
The Role of Family and Loved Ones in Substance Misuse
Through the years, studies from the Department of Veterans Affairs, the Substance Abuse and Mental Health Services Administration and other organizations have shown a relationship in service members between stressful events during training or while deployed, and later a dependence upon alcohol, tobacco or other substances. Those who have experienced such stressful events may turn to substance use to help them find relief or temporarily distract themselves from stress, upsetting memories, depression and/or troubled sleeping. Some individuals also report that chronic pain resulting from an injury can be so distracting and debilitating that they may turn to substance abuse as a way to manage the pain.
Having difficulty coping wih a traumatic event does not automatically cause problems with alcohol or substances; however, service members who have experienced combat and traumatic experiences are more likely than others to have problems with substance use. Without support, substance misuse can spiral out of control, leading to continued difficulty with combat stress, tension, sleep, relationships and managing responsiblities.
Family members can help their service member by seeking out information and understanding some of the stressors and emotions a service member may experience as they cope with substance use problems. Family members also benefit from knowing how best to offer support and encouragement. The information in this article is designed to help family members provide the care and support needed to help servicce members reach and sustain recovery.
Overcoming substance dependence can be a challenging process filled with high and low points along the way. Service members or military family members may find themselves becoming discouraged after repeated attempts to help themselves or a loved one. The best way to support a loved one exhibiting symptoms of substance dependence is to focus on the person, not the dependence - stay positive and reach out for help. Some tips for helping your loved one include:
1) Offer sympothy and support.
2) Actively listen to their concerns.
3) Acknowledge concerning behaviors.
4) Seek expert advice.
5) Consult others 'in recovery'.
6) Assist with chosen form of treatment.
1) Panic or offer pity.
2) Offer monetary assitance.
3) Set unrealistic goals.
4) Cut off dialogue.
5) Influence treatment.
Taking Care of Yourself
Admitting a substance abuse problem is a difficult task. Keeping an open mind will help create a safe environment that may encourage service members to talk more openly and seek help.
Families and friends of returning service members provide the majority of support for both physical and emotional wounds. The level of support provided differs depending on the severity and the physical location of the person. Live-in family members, such as spouses, parents or children, may take on more responsibility simply because they are more available and accessible to offer help. Whatever your role may be, it is important to remember your own psychological and physical wellness.
As you offer support to your service member, remember to take care of yourself. Caring for loved ones as they overcome challenges can have physical and emotional effects on you as the care giver. The National Military Family Association outlines the importance of remaining healthy to be able to continuing offering support to your service member. Below is a list of some suggestions for maintaining health while caring for others:
2) Stay hydrated
3) Eat right
5) Practice deep breathing
7) Stay positive and optimistic
8) Take alone time for yourself
9) Take a walk
10) Look for beauty in your daily life
Family Support Resources
Resources, in all forms, are available to help you and your service member find success. All military installations and organizations provide specialized information, resources and services - such as outreach call centers - and provide health professionals to answer questions on discussion boards. Check out the following websites for more information:
- afterdeployment.t2.health.mil - is a mental wellness resource for service members, veterans and military families. Its services focus on providing assistance through post-deployment challenges, such as coping with a substance abuse problem. Here you will find fact sheets, videos, interactive tools, self-check quizzes and more.
- Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury - maximizes opportunities for warriors and families to thrive through collaborative global networks promoting resilience, recovery and reintegration for psychological health and traumatic brain injuries. DCoE provides informational fact sheets, research updates and highlights events and conferences for more detailed information. For additional information, contact the DCoE Outreach Center 24/7: Real Warriors Live Chat by phone (1-866-966-1020) or by email (firstname.lastname@example.org)
- Military OneSource - is a 24/7 resource for military members, spouses and families filled with information, podcasts, webinars, videos, interactive tools, self-check tests, announcements and discussion boards.
- Substance Abuse Treatment Facility Locator - is a seachable directory of drug and alcohol treatment programs that shows the location of facilities around the country that treat alcoholism, alcohol abuse and drug abuse problems. The Substance Abuse Treatment Facility Locator includes more than 11,000 addiction treatment programs, including residential treatment centers, outpatient treatment programs and hospital inpatient programs for drug addiction and alcoholism. Listings include treatment programs for marijuana, cocaine and heroin addiction, as well as drug and alcohol treatment programs for adolescents and adults.
Children's Risk of Drug & Alcohol Abuse Higher In Military Families
Children in families where a parent is deployed on active military duty are more likely to binge drink, use marijuana and abuse prescription drugs compared to children in non-military families, according to a study from the University of Iowa.
Steven Arndt, a psychiatry and biostatistics professor who led the study, used data from a statewide survey of sixth, eighth, and eleventh grade students in Iowa and found an increase in drinking and drug use over in children of deployed or recently returned military parents.
"We worry a lot about the service men and women and we sometimes forget that they are not the only ones put into harm's way by deployment their families are affected, too" said Arndt in a statement. "Our findings suggest we need to provide these families with more community support."
Arndt and his team evaluated data from a 2010 Iowa Youth Survey, seeking to investigate whether military deployment of a parent was associated with children's substance abuse.
The statewide survey captured the views of more than 78,000 Iowa students as they answered questions online about attitudes and experiences with alcohol, drugs and violence as well as students' perceptions of their peers, family, school and community.
The majority of students who responded to the survey did not have a parent in the military, though about 1,800 did have a family member deployed or recently returned.
"Looking at the Iowa Youth Survey, we discovered we were right in regard to our idea that parental deployment would increase the risk for substance use behaviors in children. In fact, the numbers suggested were a lot more right than we wanted to be," Arndt said.
"For example, sixth graders in non-military families had binge drinking rates of about 2 percent. That jumps up to about 7 percent for the children of deployed or recently returned parents."
The survey encompassed a 30-day timeframe, and found that the rates for drinking alcohol were seven to nine percentage points higher for children of deployed or recently returned parents; the same group reported slightly lower binge drinking rates at five to eight percent higher than their peers.
Marijuana use was also higher, with eleventh grade students of deployed or recently returned military families five percent more likely to have used marijuana.
Iowa reportedly has large portion of the population serving with the Reserve or National Guard. These families live in civilian communities and not on military bases, where they have greater access to support services designed to help military families.
"States like Iowa that have large proportion of National Guard may be more affected by this increased risk for children," Arndt said.
"I think our findings suggest, first, that people need to be aware that for service members and their families, this is a real phenomenon, and one that should receive close attention. I would also think that schools should have a heightened awareness that children from deployed parents may need extra help."
Source: Nature World News
Children of Military Personnel
Stress among children in military families is a perennial issue. Sources of stress include ongoing features of military life such as high rates of mobility as service members are transferred, the environment for substance use, as well as the increasingly common pressure experienced by youth and their families when a parent is deployed to a war zone or other location away from home.
The number of children at risk of military-related stress is large. For 2005, the Department of Defense reported a total of nearly 1.2 million minor dependents of active duty members and about .7 million minor dependents of selected reserve members - reservists who train throughout the year and participate annually in active duty training exercises.
When Families Move
Moving frequently as service members are transferred is a common feature of military life. A survey of military teens showed they had moved five times on average. Moving also may be prompted by a military member's deployment. Military operations in recent years have increased the numbers of deployments, relocations, and family separations. Mobilization and deployment of National Guard and reserve members have increased the number of affected families.
Moving means that families experience disruption and may not be able to establish deeply rooted support systems. Families of National Guard members and reservists often life in communities without base-connected services and support systems. Support systems for military families also may be weakened by living far from extended families.
For children, the stress of moving includes leaving friends, schools, and activists and readjusting at a new location. Especially for adolescents, such transitions intensify the normal pressures of youth such as physical changes, search for identity and independence, and evolving peer and parental relationships.
The multiple moves that children in many military families go through can bring about an adjustment disorder - a severe emotional reaction to a difficult event in one's life. Frequent moves early in life may make children feel that they cannot control events in their lives. Kids may then have trouble coping when difficulties arise - effects may include feeling stressed, hopeless, or worried or acting recklessly.
Moving also may lead to academic problems due to loss of continuity of education as well as family and social disruption. Children who attend schools that serve military families also may experience academic and social problems even when their families do not move. This occurs as the academic pace slows down to accommodate arriving students and as children lose the friendship and support of friends who move away.
Moving to new communities also is likely to interrupt kids' connection to their schools as ties to teachers, activities, and school culture are cut. Because the degree of school bonding makes youth more or less likely to engage in substance abuse, youth in military families who become less connected to school as a result of moving are at increased risk for substance abuse.
A Culture of Alcohol Use
Norms, or group standards, that condone substance abuse and other problem behaviors make it more likely that people will engage in them. Young people who live on or near military bases may be at increased risk of underage drinking in view of a military culture that is favorable to alcohol use.
Rates of both heavy drinking and binge drinking among young adults in the military are higher than among civilian young adults, including full-time college students aged 18 to 22, the group with the highest rates in the general population. Military personnel often use alcohol to cope with stress, boredom, loneliness, and the lack of other recreational activities.
Research by DoD shows that active duty military personnel who drink heavily believe that drinking is part of being in the military, that drinking is the only recreation available, and that leadership tolerates off-duty drunkenness.
The alcohol culture in military life is supported by ease of access that includes low prices in base stores, frequent barracks parties, drink promotions in bars near bases, and multiple opportunities for underage drinking with friends both in and outside the armed services.
While youths in military families may not participate in the same social activities as service members or gain access to alcohol through the same channels, these young people are exposed to a climate of acceptability. Youth whose parents use alcohol and view drinking favorably tend to drink more. This connection should be interpreted carefully, however, since its influence has not been established independent of other factors.
Despite a military drinking culture, the percentage of service members aged 26 to 55 - those most likely to have adolescent children - who drink heavily is similar to the rate among civilians in the same age group. Above-average rates of heavy alcohol use are found in the Army and Marine Corps, however.
Children in military families whose parents have alcohol problems are at increased risk of becoming alcoholics. While the rate of alcoholism among military members is not known, 2.9 percent of military personnel surveyed by DoD reported symptoms of alcohol dependence that warranted further diagnostic evaluation for alcohol dependence.
A parent's deployment often brings heighened stress for military families. This stress begins when a service member is notified of a pending deployment and extends through a lengthy period after he or she returns. In the predeployment phase, children experience stress in anticipation of the parents' absence, with young children prone to confusion about why the parent is leaving and what will happen as a result. Children's stress tends to increase as they sense the strain their parents go through in preparing for separation.
In addition to new routines and responsibilities for both children and parents, deployment may involve relocation. A study of military members and service providers found that remaining parents often moved to be near extended family. While moving isolated military members' spouses from many forms of assistance, the spouses faced reduced resources during deployment if they stayed. Limited availability and accessibility of programs for children complicated their supervision during deployment.
Preschool children may be confused and surprised about everything feeling so different and feel guilty that they caused the parent to go away. As a result, their behavior may include increased demands for attention, positive and negative attention-getting behavior, trouble separating from the absent parent, irritability, aggression, and angry outbursts. Preschool children also may return to younger behavior such as thumbsucking and bedwetting. They may experience sleep disturbances, become easily frustrated and harder to comfort, and may act out scary events. Elementary school children may have the same feelings as youner children as well as sadness, anger, worry about the deployed parents' return, and fear that the remaining parent will leave, too. Behavior changes may include regression, rapid mood swings, changes in eating and sleeping, and anger toward both parents.
Older youths in military families are especially affected by parental deployment because the resulting pressures are added to the demands of normal adolescent development at a time when coping skills are not fully developed. Adolescents may become angry, sad, depressed, anxious and afraid. Youths also may find themselves confused by their emotions. In a study of 12 to 18 year olds, some youths expressed mixed feelings about their parent's absence, worrying about his or her safety while relishing freedom from criticism or discipline. Some youths were conflicted in wanting others to be supportive, yet wanting to set their stress aside. According to an expert on separation issues, the risk of deployment-related mental health problems is heightened among teens because many do not share concerns with their parents. Youths may also keep their emotions bottled up to protect a parent from negative emotions and stress. Youths also experience stress as they face added responsibilities such as doing more chores and helping to care for siblings.
Youths may cope with emotional distress by engaging in high-risk behaviors. Youths who become emotionally distressed as a result of a parent's military deployment are at increased risk for substance abuse. Adolescents also may react to emotional distress with misdirected anger such as acting out and intentionally hurting or cutting themselves; school problems, especially sudden or unusual changes; signs of apathy such as loss of interest, noncommunication, and denial of feelings, significant weight loss; regressive behavior; and friends becoming more important.
The mental health of the parent remaining at home is important in how children adjust to a parent's deployment. Characteristics that help spouses to function effectively during this time include active coping styles, making meaning of the situation, receiving community and social support, accepting the military lifestyle, showing optimism and self-reliance, and adopting flexible gender roles.
In addition, children fare better when a parent provides a consistent environment. The importance of consistency was illustrated in research with adolescents who said the worst thing about deployment was the disruption in routine, everyday life. Such disruption may lead to family management problems that are risk factors for substance abuse and other adolescent problem behaviors.
The reunification phase can be stressful for children, as returning parents may be ready to pick up family life where they left off. However, these expectations may not be realistic in view of the changes that children have undergone in the parent's absence. Adolescents may be defiant and disappointed if the returning parent does not acknowledge their contributions during the deployment. Old conflicts with the returning parent may resurface. Family management issues also may be present new problems as parents and children renogotiate their roles.
Reunion is likely to be harder for children when a parent returns with physical or psychological problems. A report to the Presidential Task Force on Military Deployment Services for Youth, Families and Service Members indicates that 23,000 service members have returned from a combat zone with physical wounds and permanent disabilities such as traumatic brain injury. As many as one-fourth of all returning service members are struggling with less visible psychological injuries including post-traumatic stress disorder (PTSD). Stress-related mental health problems and the challenges they bring to family life often emerge during the months after a service member returns home.
Children whose parents have mental health problems may have an increased risk of social, emotional, or behavior problems. Children who have a parent with a mental illness also may be at risk for substance abuse. Still, many of these children are resilient and do not have significant problms, so more research, including studies that focus on military families, is needed to find out why some children who are exposed to a parent's mental illness do well while others struggle. In addition, the postdeployment phase may not be final, since units are being deployed repeatedly into combat situations. As a result, many families face the stress of preparing for repeated deployment soon after reunion. By 2007, one-third of the approximately 1.5 million American troops deployed since September 11, 2001, had served at least two hours in combat zone and 20,000 had been deployed at least five times. Children also may face the disruption of moving if a deployed parent is killed or returns with injuries that require treatment at a distant facility.
Youths may have severe reactions if deployment results in a parent's death or trauma. For example, adolescents and teens may become depressed, withdrawn, anxious, irritable, angry, or fearful. They may have academic problems and may engage in substance abuse or other risky, antisocial, or illegal behavior.
The postdeployment phase raises the possibility of an increased risk of child abuse. Research indicates that families with service members who experience combat-related stress after their return may be at risk for increased violence against children. In addition to deployment-related issues, common features of military life - such as occupational stress, frequent separations, geographic isolation, and young familes living apart from social supports - are risk factors for child abuse. However, research has not been documented a greater occurrence of child maltreatment in military families, these children are at increased risk for substance abuse and other risky behaviors, health problems, and negative social consequences.
Possible Long-Term Effects on Health
Research suggests that high levels of stress could cause youths in military families to experience both disease and depression after in life. Traumatic life experiences such as parental unavailability, abuse, and domestic violence can cause depression while conditions such as heart disease and diabetes can result from unhealthy behavior used to cope with depression, or as a direct result of chronic stress.
While children in military families and communities face numerous stressful conditions and increase their risk of emotional problems, mistreatment and risky behavior, most of these young people fare well. Research shows that physical and mental health, as well as the activities and behaviors of adolescents living in military families, are comparable to those of youths in the civilian population.
While many youths have difficulty coping with a parent's deployment, many also become more independent and develop personal strengths in the process.
In summary, children in military families often are subject to stressful conditions stemming from difficult transitions. The frequent moving characteristic of military life disrupts children's school and social lives while a parent's deployment disrupts family life. In addition to the direct effects of these events, children are affected by their parents' circumstances and ability to cope. The various stressors that arise from these transitions increase children's risk for emotional distress, substance abuse, and other risky behavior. In addition, a culture favorable to alcohol use and abuse puts children in military families and communities at increased risk for underage drinking. While children of service members are resilient, the stressors they face call for a variety of supports for them, their parents, and their communities.
- More than half of the active duty force have family responsibilities. In 2005, 74,086 of active duty service members were single parents.
- The largest percentage of minor dependence of active duty members are between birth and 5 years old, followed by 6 to 11 year olds and almost one-fourth who are 12 to 18 years of age. The minor dependents of children of selected reserve members tend to be older - one in three are in the 12 to 18 age group.
- At any one time, more than half a million children have one or more parents deployed in support of efforts to address threats to national security.
- As of January 26, 2007, an estimated 2,733 children had lost a parent in the war in Iraq and other military operations since September 11, 2001.
- Youths who experience depression related to a parent's military service are at increased risk of substance abuse. Data from the general population show that teens who experience major depressive episodes are almost twice as likely to use illicit drugs or engage in heavy use of alcohol.
- Deployment-related child outcomes including depression, acting out or negative behavioral adjustment, poor academic performance, and increased irritability and impulsiveness have been found to be more common in boys than girls.
- Youths in military families and communities are exposed to a different substance use environment than that found in civilian life. Members of the military have higher rates of heavy alcohol use and lower rates of cigarette and illicit drug use than the civilian population, even after taking into account social and demographic differences.
- Military families may face service member behavioral health problems beyond the period of active duty. Data from 2004 to 2006 indicate that an annual average of 7.0 percent of veterans aged 18 to older experienced past year serious psychological distress, 7.1 percent met the criteria for a past year substance use disorder, and 1.5 percent had both.
- Most children in military families attend civilian schools. DoD reports 662,000 active duty service member dependents aged 6 to 18 and about 90,000 children attending DoD education activity schools worldwide.
1) MilitaryStudent.Org (www.militarystudent.dod.mil) is the official source of education information. This initiative provides information to facilitate sound decisions on the education of youths in military families. Highlights include toolkits to help parents, installation, commanders, and school leaders smooth education transitions for military children. The site also contains promising practices regarding school transitions and Sesame Street Talk, Listen Connect bilingual kits to help military families and their young children cope with deployment concerns.
2) Operation: Military Kids (www.operationmilitarykids.org/public/omk.aspx) launched in April 2005 and is the U.S Army's collaborative effort with communities to support the children and youth impacted by deployment. Through a network of community partners, OMK provides youth program opportunities for school age, middle school, and teenaged youths and connects them to support resources where they live. Families and youths can access information about OMK programs and link to partner programs on the OMK website or by contacting their State 4-H military liaison.
1) Courage to Care (www.usuhs.mil/psy/courage.html) is an electronic health campaign for military and civilian professionals serving the military community, as well as for military men, women, and families. Courage to Care consists of electronic fact sheets on timely health topics relevant to military families, including health-related aspects of moving and deployment.
2) National Military Family Association (www.nmfa.org) seeks to educate military families on their rights, benefits, and services available to them and issues that affect their lives.
3) Military Child Education Coalition (www.militarychild.org) is a nonprofit organization that identifies the challenges facing highly mobile military children. Through a wide variety of training programs, events, initiatives, and materials, MCEC helps families, schools, and communities to prepare to meet the needs of transitioning parents and students.
4) Military Child Initiative (www.jhsph.edu/mci) assists public schools in improving the quality of education for highly mobile and vulnerable young people with a special focus on military children and their families. MCI provides information, tools, and services that enhance school success to national, State, and local education agencies; schools and parents; and health, child welfare, juvenile justice, and education professionals.
5) Military Family Research Institute (www.cfs.purdue.edu/mfri/index.html) conducts original research on quality of life issues among military members and their families. Areas of interest include satisfaction, retention, readiness, and performance. The MFRI website contains research-based reports and educational materials on military demographics and military life issues including moving, marriage and divorce, family separation, and childcare.
6) Military Teens on the Move (www.defenselink.mil/mtom/index_t.htm) provides tips for kids on moving, making new friends, learning about a new community, and coping with having deployed parents. The site contains separate pages for teens and younger children.
7) Operation Healthy Reunions (www.nmha.org/reunions/index.cfm) provides education and helps to break the stigma of mental health issues among soldiors, their families, and medical staff members to ensure that a greater number of military families receive the prompt and high-quality care they deserve.
8) Uninformed Services Deployment (www.aap.org/sections/unifserv/deployment/index.htm) developed to help children and adolescents cope with the difficulties of deployment in the family. The site includes resources for youth-serving professionals and parents as well as for kids.